Reduction of transfusion requirements in pediatric craniosynostosis surgery by a new local hemostatic agent

• Published in: Journal of cranio-maxillo-facial surgery Vol. 44; no. 9; pp. 1246 - 1251
• Main Authors: Stehrer, Raphael, Hunger, Stefan, DDr, Schotten, Klaus-Jürgen, Dr, Parsaei, Babak, Dr, Malek, Michael, DDr, Jacob, Matthias, Prof. Dr, Geiselseder, Gertraud, Dr, Meier, Jens, Prof. Dr
• Format: Journal Article
• Language: English
• Published: Scotland Elsevier Ltd 01.09.2016
• Subjects: Agar; Blood Coagulation Factors; Blood Loss, Surgical - prevention & control; Blood Transfusion - statistics & numerical data; Craniosynostoses - surgery; Craniosynostosis; Dentistry; Drug Combinations; Female; Hemostatics - therapeutic use; Humans; Infant; Male; Palmitates; Patient Blood Management; Prospective Studies; RBC transfusion; Retrospective Studies; SeraSeal; Surgery; Topical hemostasis; Transfusion; Treatment Outcome; Waxes; Patient Blood Management; RBC Transfusion; SeraSeal; Transfusion; Topical hemostasis; Craniosynostosis; RBC transfusion
• ISSN: 1010-5182; 1878-4119
• DOI: 10.1016/j.jcms.2016.06.028

Abstract Background and Objectives Craniosynostosis surgery is often associated with severe perioperative bleeding especially due to venae emissariae, resulting in large transfusion amounts of packed red blood cells (PRBC). Blood loss from venae emissariae is usually reduced by the usage of bone wax. SeraSeal is a new hemostatic agent which might help to reduce transfusion amounts if used additionally to bone wax. Materials and Methods This study was designed with a retrospective control group (23 children), treated only with bone wax and a consecutive prospective verum group (12 children) treated additionally with SeraSeal. All children solely suffered from non-syndromic craniosynostosis, and were all treated by the same surgeons. Primary outcome variable was the volume of PRBC transfused during surgery. Results The numbers of PRBC transfusion was reduced significantly during the intraoperative period in the SeraSeal group (-44.5%, p<0.05) and also during the combination of the postoperative and intraoperative period (- 59.3%, p<0.05). Conclusion Our analysis suggests that SeraSeal has a strong potential to reduce transfusion requirements in pediatric craniosynostosis surgery. However, we acknowledge that due to small numbers our trial can only be seen as hypothesis generating pilot study. We suggest the effect of SeraSeal should be assessed prospectively in other studies.